Autonomic Symptom Burden and Decreased Quality of Life Among Patients With MS and NMOSD

Recently published findings in the journal Multiple Sclerosis and Related Disorders, showed a significant correlation between autonomic symptom burden and decreased quality of life among both patients living with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS), the correlation being stronger in MS.

In the study, autonomic nervous system dysfunction, defined by a total Composite Autonomic Symptom Score-31 (COMPASS-31) score greater than 0, was identified in almost all participants with NMOSD (n = 80) and MS (n = 100) tested (100%, and 97%, respectively). Notably, the median level of the total COMPASS-31 score was higher in patients with MS in comparison with patients with NMOSD, although the difference did not reach statistical significance.

All told, there was a statistically significant inverse correlation between the COMPASS-31 and Multiple Sclerosis Quality of Life-54 (MSQoL-54) scores in both patients with NMOSD and patients with MS, with stronger inverse correlation were identified in the MS group.

Senior author Jelena Drulovic, M.D., Ph.D., a professor of neurology at the University of Belgrade and head of the MS Center at the Clinic of Neurology, University Clinical Center of Serbia, and colleagues assessed autonomic nervous system dysfunction in patients with NMOSD and MS using COMPASS-31, as well as investigated the impact of autonomic nervous system dysfunction on the quality of life of these patients. The investigators conducted the study at three national referral neurological clinics in Serbia, Croatia, and Montenegro where a total of 180 participants with either MS or NMOSD were followed-up and enrolled in the study.

The median level of the orthostatic intolerance domain and the proportion of participants impacted were significantly higher among patients with MS (41%) in comparison with patients with NMOSD (15%).

Authors noted that follow-up studies are needed to confirm the obtained findings in this study and other previous studies instead of using a cross-sectional design. Another limitation authors considered was the potential lack of a nondemyelinating disorder control group. Additionally, authors recommended having a stratified analysis of patients with NMOSD and MS, according to the clinical and radiological characteristics, to help with clarifying the pathophysiology of autonomic dysfunction. Finally, authors emphasized the lack of standardized autonomic test, as the COMPASS-31 score of greater than 0 does not necessarily imply autonomic dysfunction.

This article was orignally published by Neurology Live.